血清NRG1、FGL2、FGF9与急性缺血性脑卒中后癫痫的关系及其预测价值研究

Study on the Relationship between Serum NRG1,FGL2,FGF9 and Epilepsy after Acute Ischemic Stroke and its Predictive Value

目的:探讨血清神经调节素-1(NRG1)、纤维蛋白原样蛋白2(FGL2)、成纤维细胞生长因子9(FGF9)与急性缺血性脑卒中(AIS)后癫痫的关系及其预测价值。方法:选取2021年1月~2022年3月四川大学华西医院龙泉医院收治的AIS患者450例,随访1年根据是否发生癫痫分为癫痫组(n=41)与非癫痫组(n=409)。采用酶联免疫吸附(ELISA)法检测血清NRG1、FGL2、FGF9水平。采用多因素Logistic回归分析影响AIS后癫痫的因素,采用受试者工作特征(ROC)曲线分析血清NRG1、FGL2、FGF9水平对AIS后癫痫的预测价值。结果:与非癫痫组比较,癫痫组血清NRG1、FGL2水平升高,FGF9水平降低,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,前循环梗死和梗死面积增加、出血转化、美国国立卫生研究院卒中量表(NIHSS)评分增加及NRG1、FGL2升高为影响AIS后癫痫的独立危险因素,FGF9升高为独立保护因素(P<0.05)。ROC曲线分析显示,血清NRG1、FGL2、FGF9水平联合预测AIS后癫痫的曲线下面积为0.921,大于血清NRG1、FGL2、FGF9水平单独预测的0.789、0.779、0.795。结论:血清NRG1、FGL2水平升高和FGF9水平降低与AIS后癫痫发生密切相关,血清NRG1、FGL2、FGF9水平联合检测对预测AIS后癫痫发生具有较高价值。

Objective:To investigate the relationship between serum neuromodulin-1(NRG1),fibrinogen-like protein 2(FGL2),fibroblast growth factor 9(FGF9)and epilepsy after acute ischemic stroke(AIS)and its predictive value.Methods:450 AIS patients admitted to Longquan Hospital of Sichuan University West China Hospital from January 2021 to March 2022 were selected,and the patients were divided into epilepsy group(n=41)and non-epilepsy group(n=409)according to whether epilepsy occurred after 1 year of follow-up.The levels of serum NRG1,FGL2 and FGF9 were detected by enzyme-linked immunosorbent assay(ELISA).The factors affecting epilepsy after AIS were analyzed by multivariate Logistic regression analysis,and the predictive value of serum NRG1,FGL2and FGF9 levels for epilepsy after AIS were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with non-epileptic group,the serum levels of NRG1 and FGL2 in epileptic group increased,and the FGF9 level decreased,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that anterior circulation infarction,the increased infarct area,hemorrhagic transformation,the increase of National Institute of Health stroke scale(NIHSS)score,NRG1 and FGL2 were independent risk factors for epilepsy after AIS,and the increase of FGF9 was an independent protective factor(P<0.05).ROC curve analysis showed that the area under the curve of serum NRG1,FGL2 and FGF9 levels combined to predict epilepsy after AIS was 0.921,which was greater than 0.789,0.779 and 0.795 predicted by serum NRG1,FGL2 and FGF9 levels alone.Conclusion:The increased serum NRG1 and FGL2 levels and decreased FGF9 levels are closely associated with epilepsy after AIS,and the combined detection of serum NRG1,FGL2,and FGF9 levels is of high value in predicting epilepsy after AIS.